Prevalence, years lived with disability, and trends in anaemia burden by severity and cause, 1990–2021: findings from the Global Burden of Disease Study 2021
Authors: William M Gardner, Christian Razo, Theresa A McHugh, Hailey Hagins, Victor M Vilchis-Tella, Conor Hennessy, Heather Jean Taylor, Nandita Perumal, Kia Fuller, Kelly M Cercy, Leo Zucker Zoeckler, Catherine S Chen, Stephen S Lim, Amirali Aali, Kalkidan Hassen Abate, Sherief Abd-Elsalam, Ame Mehadi Abdurehman, Getachew Abebe, Hassan Abidi, Richard Gyan Aboagye, Hassan Abolhassani, Girma Beressa Aboye Aboye, Yonas Derso Abtew, Manfred Mario Kokou Accrombessi, Denberu Eshetie Adane Adane, Tigist Demssew Adane, Isaac Yeboah Addo, Miracle Ayomikun Adesina, Daniel Adedayo Adeyinka, Qorinah Estiningtyas Sakilah Adnani, Muhammad Sohail Afzal, Saira Afzal, Rina Agustina, Bright Opoku Ahinkorah, Aqeel Ahmad, Sajjad Ahmad, Sepideh Ahmadi, Ayman Ahmed, Tarik Ahmed Rashid, Wajeeha Aiman, Marjan Ajami, Hossein Akbarialiabad, Fares Alahdab, Ziyad Al-Aly, Nazmul Alam, Astawus Alemayehu, Robert Kaba Alhassan, Muhammad Ashar Ali, Sami Almustanyir, Rajaa M Al-Raddadi, Rami H Al-Rifai, Khalid A Altirkawi, Saba Alvand, Nelson Alvis-Guzman, Yasser Sami Abdel Dayem Amer, Edward Kwabena Ameyaw, Hubert Amu, Tadele Fentabil Anagaw, Robert Ancuceanu, Ali Arash Anoushirvani, Maxwell Hubert Antwi, Davood Anvari, Jalal Arabloo, Aleksandr Y Aravkin, Hany Ariffin, Timur Aripov, Asrat Arja, Michael Benjamin Arndt, Judie Arulappan, Raphael Taiwo Aruleba, Tahira Ashraf, Melash Belachew Asresie, Seyyed Shamsadin Athari, Daniel Atlaw, Avinash Aujayeb, Andargie Abate Awoke, Mamaru Ayenew Awoke, Sina Azadnajafabad, Mohammadreza Azangou-Khyavy, Darshan B B, Alaa Badawi, Ashish D Badiye, Nayereh Baghcheghi, Nasser Bagheri, Sara Bagherieh, Atif Amin Baig, Maciej Banach, Palash Chandra Banik, Abere Tilahun Bantie, Ronald D Barr, Amadou Barrow, Azadeh Bashiri, Saurav Basu, Abdul-Monim Mohammad Batiha, Tahmina Begum, Melaku Ashagrie Belete, Luis Belo, Isabela M Bensenor, Alemshet Yirga Berhie, Akshaya Srikanth Bhagavathula, Nikha Bhardwaj, Pankaj Bhardwaj, Ajay Nagesh Bhat, Zulfiqar A Bhutta, Boris Bikbov, Sk Masum Billah, Setognal Birara, Jessica Devin Bishai, Saeid Bitaraf, Archith Boloor, João Silva Botelho Botelho, Katrin Burkart, Daniela Calina, Francieli Cembranel, Promit Ananyo Chakraborty, Gashaw Sisay Chanie, Vijay Kumar Chattu, Ju-Huei Chien, Isaac Sunday Chukwu, Eunice Chung, Michael H Criqui, Natália Cruz-Martins, Omid Dadras, Gizachew Worku Dagnew, Xiaochen Dai, Hadi A Danawi, Lalit Dandona, Rakhi Dandona, Aso Mohammad Darwesh, Jai K Das, Saswati Das, Vanessa De la Cruz-Góngora, Fitsum Wolde Demisse, Solomon Demissie, Desalegn Getnet Demsie, Hardik Dineshbhai Desai, Markos Desalegn Desalegn, Fikadu Nugusu Dessalegn, Gashaw Dessie, Samath Dhamminda Dharmaratne, Meghnath Dhimal, Sameer Dhingra, Daniel Diaz, Mojtaba Didehdar, M Ashworth Dirac, Mengistie Diress, Saeid Doaei, Milad Dodangeh, Paul Narh Doku, Deepa Dongarwar, Bezabih Terefe Dora, Haneil Larson Dsouza, Hisham Atan Edinur, Michael Ekholuenetale, Ahmed Elabbas Mustafa Elagali, Mostafa Ahmed Elbahnasawy, Iffat Elbarazi, Ghada Metwally Tawfik ElGohary, Muhammed Elhadi, Waseem El-Huneidi, Mohamed A Elmonem, Daniel Berhanie Enyew, Habitu Birhan Eshetu, Samuel B Ewald, Rana Ezzeddini, Adeniyi Francis Fagbamigbe, Abidemi Omolara Fasanmi, Ali Fatehizadeh, Ginenus Fekadu, Bikila Regassa Feyisa, Florian Fischer, Ryan Fitzgerald, Masoud Foroutan, Kayode Raphael Fowobaje, Muktar A Gadanya, Abhay Motiramji Gaidhane, Santosh Gaihre, Abduzhappar Gaipov, Yaseen Galali, Nasrin Galehdar, Priyanka Garg, Tushar Garg, Yosef Haile Gebremariam, Ketema Bizuwork Gebremedhin, Berhe Gebremichael, Yibeltal Yismaw Gela, Urge Gerema, Lemma Getacher, Kazem Ghaffari, Mansour Ghafourifard, Seyyed-Hadi Ghamari, Mohammad Ghasemi Nour, Ahmad Ghashghaee, Maryam Gholamalizadeh, Sherief Ghozy, Abraham Tamirat T Gizaw, James C Glasbey, Mahaveer Golechha, Pouya Goleij, Mohamad Golitaleb, Alessandra C Goulart, Girma Garedew Goyomsa, Habtamu Alganeh Guadie, Mohammed Ibrahim Mohialdeen Gubari, Zewdie Gudisa, Damitha Asanga Gunawardane, Rahul Gupta, Rajat Das Gupta, Sapna Gupta, Vivek Kumar Gupta, Alemu Guta, Parham Habibzadeh, Samer Hamidi, Alexis J Handal, Asif Hanif, Md Abdul Hannan, Harapan Harapan, Mehdi Harorani, Ahmed I Hasaballah, Md Mehedi Hasan, Hamidreza Hasani, Hadi Hassankhani, Mohammed Bheser Hassen, Simon I Hay, Khezar Hayat, Golnaz Heidari, Sonja Y Hess, Demisu Zenbaba Heyi, Kamal Hezam, Yuta Hiraike, Ramesh Holla, Sheikh Jamal Hossain, Kaveh Hosseini, Mohammad-Salar Hosseini, Mehdi Hosseinzadeh, Mihaela Hostiuc, Sorin Hostiuc, Junjie Huang, Salman Hussain, Foziya Mohammed Hussien, Segun Emmanuel Ibitoye, Olayinka Stephen Ilesanmi, Irena M Ilic, Mustapha Immurana, Leeberk Raja Inbaraj, Sheikh Mohammed Shariful Islam, Nahlah Elkudssiah Ismail, Linda Merin J, Elham Jamshidi, Manthan Dilipkumar Janodia, Umesh Jayarajah, Shubha Jayaram, Rime Jebai, Bedru Jemal, Angeline Jeyakumar, Ravi Prakash Jha, Jost B Jonas, Nitin Joseph, Jacek Jerzy Jozwiak, Ali Kabir, Laleh R Kalankesh, Rohollah Kalhor, Vineet Kumar Kamal, Himal Kandel, Tesfaye K Kanko, Ibraheem M Karaye, Faizan Zaffar Kashoo, Patrick DMC Katoto, Joonas H Kauppila, Harkiran Kaur, Gbenga A Kayode, Adera Debella Kebede, Vikash Ranjan Keshri, Mohammad Keykhaei, Yousef Saleh Khader, Himanshu Khajuria, Nauman Khalid, Mohammad Khammarnia, Imteyaz A Khan, Moien AB Khan, Khaled Khatab, Zaher Khazaei, Jagdish Khubchandani, Yun Jin Kim, Ruth W Kimokoti, Sezer Kisa, Farzad Kompani, Soewarta Kosen, Sindhura Lakshmi Koulmane Laxminarayana, Kewal Krishan, Barthelemy Kuate Defo, Mohammed Kuddus, G Anil Kumar, Naveen Kumar, Nithin Kumar, Om P Kurmi, Oluwatosin Kuti, Dharmesh Kumar Lal, Iván Landires, Anders O Larsson, Zohra S Lassi, Kamaluddin Latief, Avula Laxmaiah, Caterina Ledda, Sang-woong Lee, Samson Mideksa Legesse, Xuefeng Liu, László Lorenzovici, Vanessa Sintra Machado Machado, Preetam Bhalchandra Mahajan, Soleiman Mahjoub, Ata Mahmoodpoor, Elham Mahmoudi, Elaheh Malakan Rad, Tauqeer Hussain Mallhi, Deborah Carvalho Malta, Sahar Masoudi, Seyedeh Zahra Masoumi, John Robert Carabeo Medina, Fabiola Mejia-Rodriguez, José João Mendes Mendes, Walter Mendoza, Oliver Mendoza-Cano, Alexios-Fotios A Mentis, Haftu Asmerom Meresa, Tomislav Mestrovic, Tomasz Miazgowski, Mojgan Mirghafourvand, Andreea Mirica, Moonis Mirza, Awoke Misganaw, Sanjeev Misra, Dara K Mohammad, Shadieh Mohammadi, Shafiu Mohammed, Syam Mohan, Nagabhishek Moka, Ali H Mokdad, Sara Momtazmanesh, Lorenzo Monasta, Mohammad Ali Moni, Delaram Moosavi, Maryam Moradi, Abbas Mosapour, Ebrahim Mostafavi, Temesgen Muche, Francesk Mulita, Getaneh Baye Mulu, Christopher J L Murray, Ana-Maria Musina, Ghulam Mustafa, Ahamarshan Jayaraman Nagarajan, Tapas Sadasivan Nair, Sreenivas Narasimha Swamy, Hasan Nassereldine, Zuhair S Natto, Biswa Prakash Nayak, Shumaila Naz, Ionut Negoi, Ruxandra Irina Negoi, Georges Nguefack-Tsague, Josephine W Ngunjiri, Robina Khan Niazi, Maryam Noori, Ali Nowroozi, Dieta Nurrika, Khan M Nuruzzaman, Ogochukwu Janet Nzoputam, Bogdan Oancea, Rahman Md Obaidur, Mohammed Mohammed Suleiman Suleiman Obsa, Julius Nyerere Odhiambo, Ropo Ebenezer Ogunsakin, Hassan Okati-Aliabad, Osaretin Christabel Okonji, Adeolu Olufunso Oladunjoye, Olubunmi Omotola Oladunjoye, Andrew T Olagunju, Isaac Iyinoluwa Olufadewa, Ahmed Omar Bali, Abidemi E Emmanuel Omonisi, Alberto Ortiz, Mayowa O Owolabi, Jagadish Rao Padubidri, Reza Pakzad, Tamás Palicz, Anamika Pandey, Apurva Kumar Pandya, Paraskevi Papadopoulou, Shahina Pardhan, Jay Patel, Ashish Pathak, Aslam Ramjan Pathan, Rajan Paudel, Uttam Paudel, Shrikant Pawar, Gavin Pereira, Norberto Perico, Simone Perna, Navaraj Perumalsamy, Ionela-Roxana Petcu, Brandon V Pickering, Zahra Zahid Piracha, Richard Charles G Pollok, Pranil Man Singh Pradhan, Akila Prashant, Ibrahim Qattea, Zahiruddin Quazi Syed, Fakher Rahim, Mehran Rahimi, Azizur Rahman, Mohammad Hifz Ur Rahman, Mosiur Rahman, Amir Masoud Rahmani, Shayan Rahmani, Rajesh Kumar Rai, Ivano Raimondo, Sathish Rajaa, Pradhum Ram, Juwel Rana, Muhammad Modassar Ali Nawaz Ranjha, Chythra R Rao, Sowmya J Rao, Sina Rashedi, Mohammad-Mahdi Rashidi, Salman Rawaf, Lal Rawal, Rabail Zehra Raza, Elrashdy Moustafa Mohamed Redwan, Giuseppe Remuzzi, Maryam Rezaei, Nazila Rezaei, Negar Rezaei, Toby Richards, Jennifer Rickard, Jefferson Antonio Buendia Rodriguez, Leonardo Roever, Gholamreza Roshandel, Bedanta Roy, Godfrey M Rwegerera, Aly M A Saad, Siamak Sabour, Basema Saddik, Malihe Sadeghi, Saeid Sadeghian, Umar Saeed, Amirhossein Sahebkar, Harihar Sahoo, Marwa Rashad Salem, Abdallah M Samy, Senthilkumar Sankararaman, Rocco Santoro, Itamar S Santos, Maheswar Satpathy, Ganesh Kumar Saya, Binyam Tariku Seboka, Anbissa Muleta Senbeta, Subramanian Senthilkumaran, Allen Seylani, Melika Shafeghat, Pritik A Shah, Masood Ali Shaikh, Mohd Shanawaz, Mohammed Shannawaz, Mequannent Melaku Sharew Sharew, Purva Sharma, Rahim Ali Sheikhi, Suchitra M Shenoy, Adithi Shetty, B Suresh Kumar Shetty, Jeevan K Shetty, Pavanchand H Shetty, Jae Il Shin, Siddharudha Shivalli, Velizar Shivarov, Parnian Shobeiri, Seyed Afshin Shorofi, Mustafa Kamal Sikder, Ali Reza Sima, Wudneh Simegn, Jasvinder A Singh, Narinder Pal Singh, Paramdeep Singh, Surjit Singh, Md Shahjahan Siraj, Yordanos Sisay, Anna Aleksandrovna Skryabina, Yonatan Solomon, Yi Song, Reed J D Sorensen, Jeffrey D Stanaway, Parminder S Suchdev, Mu'awiyyah Babale Sufiyan, Saima Sultana, Mindy D Szeto, Seidamir Pasha Tabaeian, Alireza Tahamtan, Majid Taheri, Moslem Taheri Soodejani, Zemenu Tamir, Ker-Kan Tan, Md Tariqujjaman, Elvis Enowbeyang Tarkang, Nathan Y Tat, Yibekal Manaye Tefera, Mohamad-Hani Temsah, Rekha Thapar, Arulmani Thiyagarajan, Jansje Henny Vera Ticoalu, Bereket M Tigabu, Amir Tiyuri, Ruoyan Tobe-Gai, Marcos Roberto Tovani-Palone, Mai Thi Ngoc Tran, Biruk Shalmeno Tusa, Irfan Ullah, Abdurezak Adem Umer, Bhaskaran Unnikrishnan, Marco Vacante, Sahel Valadan Tahbaz, Pascual R Valdez, Priya Vart, Shoban Babu Varthya, Siavash Vaziri, Madhur verma Verma, Massimiliano Veroux, Dominique Vervoort, Linh Gia Vu, Birhanu Wagaye, Fitsum Weldegebreal, Nuwan Darshana Wickramasinghe, Melat Woldemariam, Tewodros Eshete Wonde, Gedif Ashebir Wubetie, Xiaoyue Xu, Kheirollah Yari, Fereshteh Yazdanpanah, Sisay Shewasinad Yehualashet, Arzu Yigit, Vahit Yiğit, Eshetu Yisihak, Dong Keon Yon, Naohiro Yonemoto, Melissa F Young, Chuanhua Yu, Ismaeel Yunusa, Mazyar Zahir, Leila Zaki, Burhan Abdullah Zaman, Nelson Zamora, Iman Zare, Zahra Zareshahrabadi, Getachew Assefa Zenebe, Zhi-Jiang Zhang, Peng Zheng, Mohammad Zoladl, Nicholas J Kassebaum
Journal: The Lancet Haematology (2023)

Anaemia is a major health problem worldwide. Global estimates of anaemia burden are crucial for developing appropriate interventions to meet current international targets for disease mitigation. We describe the prevalence, years lived with disability, and trends of anaemia and its underlying causes in 204 countries and territories.We estimated population-level distributions of haemoglobin concentration by age and sex for each location from 1990 to 2021. We then calculated anaemia burden by severity and associated years lived with disability (YLDs). With data on prevalence of the causes of anaemia and associated cause-specific shifts in haemoglobin concentrations, we modelled the proportion of anaemia attributed to 37 underlying causes for all locations, years, and demographics in the Global Burden of Disease Study 2021.In 2021, the global prevalence of anaemia across all ages was 24·3% (95% uncertainty interval [UI] 23·9-24·7), corresponding to 1·92 billion (1·89-1·95) prevalent cases, compared with a prevalence of 28·2% (27·8-28·5) and 1·50 billion (1·48-1·52) prevalent cases in 1990. Large variations were observed in anaemia burden by age, sex, and geography, with children younger than 5 years, women, and countries in sub-Saharan Africa and south Asia being particularly affected. Anaemia caused 52·0 million (35·1-75·1) YLDs in 2021, and the YLD rate due to anaemia declined with increasing Socio-demographic Index. The most common causes of anaemia YLDs in 2021 were dietary iron deficiency (cause-specific anaemia YLD rate per 100 000 population: 422·4 [95% UI 286·1-612·9]), haemoglobinopathies and haemolytic anaemias (89·0 [58·2-123·7]), and other neglected tropical diseases (36·3 [24·4-52·8]), collectively accounting for 84·7% (84·1-85·2) of anaemia YLDs.Anaemia remains a substantial global health challenge, with persistent disparities according to age, sex, and geography. Estimates of cause-specific anaemia burden can be used to design locally relevant health interventions aimed at improving anaemia management and prevention.Bill & Melinda Gates Foundation.